Medicaid Expansion Has a Significant Impact on Access to Health Care for Cancer Survivors

Medicaid benefits are an important part of the health care landscape for low-income cancer survivors, according to an analysis published in the Journal of Cancer Survivorship (doi:10.1007/s11764-015-0504-5).

Understanding the impact of Medicaid expansion under the Affordable Care Act (ACA) on cancer survivors' access to health care requires first defining access to health care before the ACA, explained Cathy J. Bradley, PhD, associate director for Population Science at the University of Colorado Cancer Center and professor in the Colorado School of Public Health in Aurora. In states that expanded Medicaid coverage prior to the ACA, cancer survivors had more access to health care than survivors in states that had not expanded Medicaid.

"Populations most affected are the low-income and uninsured. If cancer survivors cannot get the follow-up care they need, recurrences may be missed and long-term consequences of cancer treatment may not be appropriately managed," said Bradley.

Data from the 2012 and 2013 Behavioral Risk Factor Surveillance System, which collects annual health data of more than 400,000 people living in the United States was used to determine whether cancer survivors across states had personal doctors, received an annual checkup, and reported inability to see a doctor because of cost.

Before the ACA, cancer survivors in states that did not expand their Medicaid programs were less likely to have a personal doctor and more likely to report that they could not afford the cost of seeing a doctor (odds ratios 0.76 and 1.14, respectively). Other possible factors that could determine access were controlled in this study. Reasons for these disparities were outside the scope of this study.

"While cancer survivors are at high risk of developing other cancers and experiencing late effects of treatment, our findings imply that survivors living in nonexpansion states are less likely to access health care services that are necessary to receive the care they need," said the authors.

The authors conclude that low-income cancer survivors benefit from access to Medicaid programs. Their findings set the stage for continuing analysis of the impact of the ACA on health care access and health outcomes for cancer survivors.